Vascular dementia is the second most common type of dementia and is caused by multiple strokes which damages the brain and therefore results in cognitive decline. The symptoms for vascular dementia are similar to alzheimer's disease (memory impairement and one or more of aphasia, apraxia, agnosia and problems with executive functioning) however includes cerebrovascular disease or focal neurological signs that are related to the symptoms of vascular dementia. The onset of vascular dementia is usually rapid however it can be patchy, depending on the where the damage of the brain is located.
While vascular dementia is caused by strokes and the risk factors of a stroke includes, physical inactivity, heavy or binge drinking, being overweight and drug use researchers have been investigating if improved health will indeed reduce the risk of various types of dementia including vascular dementia.
As a result, researchers have found that diet, exercise and mental stimulation will help prevent the onset of dementia. Social activity is also another preventative measure. Moreover, researchers have found that it is best to consider all the preventative methods being exercise, diet, mential stimulation and social activity together rather than one alone.
While studies have investigated the relationship of physical activity and alzheimers, it has also investigated the relationship between physical activity and vascular dementia with mixed findings.
Positive results include walking according to current health guidelines (3 times a week, 30 minutes each time) is associated with a 34% reduction in the risk of cognitive impairment. It is however recommended to exceed the current health guidelines, which may in turn increase benefits. Another study also found that physical activity improved cognitivie functioning in people who were at risk for dementia. The participants in the study had cognitive impairment, which improved after a 24-week home based physical activity program. Improvements were found 12 months after the intervention.
As the research indicates that physical activity can reduce the risk of vascular dementia, it is important to encourage people to exercise; especially for people who are at risk of cerebrovascular disease. Physical activity should be included in prevention programs.
Environmental and social factors needs to support the increase in a person's level of physical activity. Currently there are many western people who don't do the recommended levels.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Dag Aarsland , Farzaneh S. Sardahaee , Sigmund Anderssen , Clive Ballard & the Alzheimer's Society Systematic Review group (2010) Is physical activity a potential preventive factor for vascular dementia? A systematic review, Aging & Mental Health, 14:4, 386-395, DOI: 10.1080/13607860903586136
There has been a lot of discussion over the years about misdiagnosing people who are thought to have attention deficit hyperactivity disorder (ADHD) but may in fact be gifted.
People who are gifted tend to misbehave if they are bored and not challenged, have a lot of energy, usually need less sleep (resembling hyperactivity), argue with authority figures because they have a need to question everything, lose their ability to attend because their mind is full of new ideas and overloaded with thoughts which causes them to lose focus (resembling inattention) and act without a lot of thought, which can result in risky behaviour (resembling impulsivity).
It is also known that both the ADHD and the gifted can experience underachievement and and be inept socially. Moreover, both the ADHD and gifted people can experience overexcitabilities in any of the psychomotor, sensual, intellectual, imaginational and emotional domains. This means that they can be intense in any of these areas.
It is also important to realise that the person may have both ADHD and giftedness. This means that the person is known to be twice exceptional because he or she has two types of special needs (one being from ADHD symptoms and the other from the symptoms of giftedness).
It is therefore important for the parent or the person receiving the diagnosis to be an informed client so he or she is ready to question the outcome as some clinicians may not be fully aware of the possibility of misdiagnosis or specialised in assessing or treating people with ADHD or the gifted, which in turn will result in the wrong type of treatment and worst of all given medication when there is no reason for it.
Diagnosis in an adult should take at least three hours as suggested by Dr Kevin Murphy from the Adult ADHD Clinic U. in Massachusetts Medical Centre. The diagnosis will include a computerised test, a clinical interview with the client, an interview with the client's parents (if still alive) and their spouse or other close person to the adult. Children's diagnosis will also include interviews and assessments from the teacher and parent as well as from the child. It has been known that some doctors used to test if the child had ADHD by seeing if they reacted differently to the drug Ritalin. If the child did improve then they were to be considered to have the diagnosis of ADHD, however, it was later found that any non-ADHD person will have some change in attention and behaviour with Ritalin. To put this in another way, be an informed client to ensure that you are receiving the correct diagnosis, as the diagnosis will inform the type of treatment and support you will receive.
Lastly, the correct diagnosis will also inform how you see yourself - with a disorder or a gift. But should ADHD really be considered a disorder? For example if ADHD symptoms are similar to giftedness then why should one be considered a disorder and the other a gift? There are many people who have ADHD already challenging the notion that it should be not considered a disorder, but symptoms that society needs to adapt to. With the right strategies and support, the person with ADHD and the person with giftedness will both thrive.
D. Niall Hartnett , Jason M. Nelson & Anne N. Rinn (2004) Gifted or ADHD? The possibilities of misdiagnosis, Roeper Review, 26:2, 73-76, DOI: 10.1080/02783190409554245
Edwards, K. (2009). Misdignosis, the recent trend in thinking about gifted children with ADHD. APEX, 15(4), 29-44. Retrieved online from http://www.giftedchildren.or.nz/apex.
Josephine will update you with the latest and relevant research and discussions about mental health for adults, children and young people as well as money & behaviour, parenting strategies and learning